BMJ 1995;311:126 (8 July)

Letters

Promoting cost effective prescribing

Cost effectiveness studies may not be cost effective

EDITOR,--Nick Freemantle and colleagues criticise the NHS for lagging behind Australia and Canada in promoting cost effective prescribing.1 As members of the working group that agreed the British guidance on conducting economic evaluations2 we take issue with their claim that these countries have a preferable approach.

There is no evidence that Australia and Canada have more cost effective prescribing than the United Kingdom. They have centralised reimbursement lists (federal and provincial, respectively), requiring the submission of information on cost effectiveness. Such submissions should improve decision making, but costs are attached to the process. Neither country has evaluated how cost effective these procedures are.

The United Kingdom does not have a central reimbursement list. General practitioners have budgetary responsibility to encourage them to match the cost of prescribing with expected health gain. Increases in generic prescribing, reviews of repeat prescriptions, and a greater . . . [Full text of this article]


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Relevant Article

Promoting cost effective prescribing
Nick Freemantle, David Henry, Alan Maynard, and George Torrance
BMJ 1995 310: 955-956. [Extract] [Full Text]

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